Drugs

Dopamine (DA) : Therapeutic uses, Dosage & Side Effects

Dopamine : Therapeutic uses, Dosage & Side Effects

Dopamine (cathecholamine) is a adrenergic agonist (direct acting). Dopamine is a medication form of a substance that occurs naturally in the body.
Dopamine injection (Intropin) is used to treat certain conditions, such as low pressure, that occur when you are in shock, which may be caused by heart attack, trauma, surgery, heart failure, kidney failure, and other serious medical conditions. It works by improving the pumping strength of the heart and improves blood flow to the kidneys.
Dose : 0.2-1 mg /min. I.V. infusion
Route : Intravenous
Onset of action : Within five minutes of intravenous administration
Plasma half-life : About 2 minutes
Duration of action : Less than ten minutes
Bioavailability : High
Chemical formula : C8H11NO2
IUPAC name : 4-(2-Aminoethyl)benzene-1,2-diol
Trade name : Intropin, Myocard-DX (dopamine hydrochloride in dextrose)
Therapeutic uses : Dopamine has following usage:

  • Used as drug of choice for cardiogenic and septic shock owing to increase in total peripheral resistance & blood pressure and thereby, cardiac output.
  • Used in the treatment of severe congestive heart failure & hypotension, particularly in patients with oliguria and low or normal peripheral vascular resistance.

Points of interest :

  • Dopamine is far superior to norepinephrine because dopamine enhances perfusion (or blood flow) to the kidney and splanchnic areas and thereby, glomerular filtration rate and causes diuresis whereas norepinephrine diminishes blood supply to the kidney and may cause renal shutdown.
  • During the infusion, patients require clinical assessment of myocardial function, perfusion of vital organs such as the brain, and the production of urine.
  • Most patients should receive intensive care, with monitoring of arterial and venous pressures and the ECG.
  • It does not penetrate blood-brain barrier-no CNS effects.

Side effects : Adverse effects of Dopamine are as follows:

  • Nausea,
  • Vomiting,
  • Tachycardia,
  • Anginal pain,
  • Arrhythmias,
  • Headache,
  • Hypertension,
  • Peripheral vasoconstriction
  • Tissue necrosis & sloughing of skin (if extravasation occurs)
  • Gangrene of the fingers or toes

Dopamine is rapidly metabolized by MAO or COMT, and its adverse effects (nausea, hypertension, and arrhythmias) are, therefore, short-lived.
Warnings :

  • Contains sodium metabisulfite, a sulfite that may cause allergic-type reactions including anaphylactic cymptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people.
  • Do NOT add dopamineHCl to any alkaline diluent solution since the drug is inactivated in alkaline solution.
  • Patients who have been receiving MAO inhibitors prior to the administration of dopamine HCl will require substantially reduced dosage.

Contraindications :

  • DopamineHCl should not be used in patients with pheochromacytoma.
  • DopamineHCl should not be administered to patients with uncorrected tachyarrhythmias or ventricular fibrillation.

For detailed query or in case of uncertainty, Always consult your doctor or pharmacist

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